Value of Office-Based Transrectal Three-Dimensional Ultrasound for Diagnosis of Acute Dysuria of the Prostatic Urethra

Abstract

Value of Office-Based Transrectal Three-DimensionalUltrasound for Diagnosis of Acute Dysuria of the Prostatic Urethra Abbreviations and Acronyms2D = 2-dimensional 3D = 3-dimensional E. coli = Escherichia coli ROI = region of interest TRUS = transrectal ultrasound US = ultrasound ABSTRACT KEYWORDS: Three-dimensional transrectal ultrasound (3D TRUS); Prostatic urethra; acute dysuria CORRESPONDENCE: INTRODUCTION: The purpose of the study was to compare the accuracy of plain radiography, 2-dimensional (2D), and 3-dimensional (3D) transrectal ultrasound (TRUS) in diagnosing the causes of acute dysuria, as confirmed by urethroscopy or laboratory findings. METHODS: Participants were 122 men with clinical presentation of acute dysuria who were previously known to be healthy. Their mean age was 28 years (range, 17-49 years). All patients received a plain radiograph of the urinary tract. A SonoAce X8 ultrasound system (Medison America Inc; Cypress, CA, USA) was used to obtain both 2D and 3D TRUS. Voiding-related symptoms, cause of the dysuria, location, and morphology of the lesions were recorded. The results of the plain radiograph, 2D TRUS, and 3D TRUS were compared with the results of urethroscopy or laboratory findings to determine diagnostic accuracy. RESULTS: Of the total 122 patients, 113 patients (92.6%) had calcular obstruction of the prostatic urethra; 7 patients (5.7%) had variants of severe urethritis; 2 patients (1.6%) had benign urethral polyps. In cases of calcular obstruction, plain radiography revealed 76.7% of radiopaque stones, the 2D TRUS revealed 80.2% of stones, and the 3D TRUS with high threshold revealed 99.1%. Both 2D TRUS and 3D TRUS with low-threshold technique revealed the polyps and accurately defined their pattern and site. Three-dimensional TRUS descriptions of inflammatory lesions and their effect on periurethral tissues were dissimilar from each other and suggestive of different types. CONCLUSION: Three-dimensional TRUS imaging may play an important role in the pretreatment evaluation of acute dysuria that is caused by different impeding factors. UroToday International Journal ® UI J